Provider Demographics
NPI:1003484676
Name:BOBB, CATHY MARIA (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:MARIA
Last Name:BOBB
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-4324
Mailing Address - Country:US
Mailing Address - Phone:337-909-2828
Mailing Address - Fax:
Practice Address - Street 1:625 CORPORATE BLVD
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-4324
Practice Address - Country:US
Practice Address - Phone:337-909-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3959235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist